UBC Theses and Dissertations
Pharmacogenomics : from experimental design through patient interactions Breaux, Samantha
In this study 180 patients were consented and enrolled for pharmacogenomic testing based on their current antidepressant/antipsychotic usage. Samples from patients were genotyped by PCR, massARRAY, and targeted for next generation sequencing. We also conducted a quantitative, frequency-based analysis of participants’ perceptions using simple surveys. Pharmacogenomic information, including medication changes and altered dosing recommendations were returned to the pharmacists and used to direct patient therapy. Overwhelmingly, patients perceived pharmacists/pharmacies as an appropriate healthcare provider to deliver pharmacogenomic services. In total, there were 81 medication changes in 33 unique patients, representing 22% of all genotyped participants. We performed a simple drug cost analysis and found that medication adjustments and dosing changes across the entire cohort added $24.15CAD per patient per year for those that required an adjustment. Comparing different platforms, we uncovered a small number (1.7%) of genotype discrepancies, none of which impacted medication suggestions. We conclude that: 1) Pharmacists are competent providers of pharmacogenomic services. 2) The potential reduction in adverse drug responses and optimization of drug selection and dosing comes at a minimal cost to the health care system. 3) Changes in drug therapy, based on PGx tests, result in inconsequential changes in annual drug therapy cost with small cost increases just as likely as costs savings. 4) Pharmacogenomic services offered by pharmacists are ready for wide commercial implementation. This thesis details the methods and results from this study in relation to pharmacogenomics as a concept and its practice across British Columbia and Canada.
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